Provider Demographics
NPI:1376289652
Name:MAULT, ASHLEY WHITNEY (SLPA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:WHITNEY
Last Name:MAULT
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 DECKER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-4129
Mailing Address - Country:US
Mailing Address - Phone:972-739-6070
Mailing Address - Fax:
Practice Address - Street 1:320 DECKER DR STE 100
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4129
Practice Address - Country:US
Practice Address - Phone:972-739-6070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX421562355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant